Publication:

Sinonasal papillomas in Quito, Ecuador

Background Sinonasal inverted papilloma is an unusual tumor of the nasal cavity and paranasal sinuses with potential for malignant transformation. The objective was to review the experience mostly using a similar open surgical approach.

Methods Twenty-eight patients were included. Mean age was 54, 57% of male gender. five patients were previously operated elsewhere, twenty-five had unilateral complete nasal obstruction and mean duration of symptoms was 8months. A computed tomography was performed in all patients. The tumor was located within the nasal cavity in 9 cases, limited to the ethmoid sinus complex in one, extended to the maxillary sinus in 16 and to the nasopharynx or palate in one, each. Mean size was 5.2cm. Twenty-seven cases were benign and one was a transitional carcinoma originated in an inverted papilloma. Surgical resection of the tumor was performed through a Denker’s approach in all the benign cases except a lateral rhinotomy in one recurrent lesion of limited ethmoid involvement. A partial maxillectomy was performed in the patient with malignancy. Minor postoperative complications occurred in 3 patients which was nasal bleeding, a cellulitis of the cheek with exophtalmus and an oro-antral fistula.

Results After a mean follow-up of 33.6months, recurrent benign tumors were easily resected through the same approach in 5 patients. All patients have currently no evidence of disease.

Conclusions Denker’s approach was a very useful, rapid and safe surgical approach for treatment of middle size or extended sinonasal inverted papillomas and remains an alternative to current endoscopic resection.